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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2010 Dec;25(8):641–649. doi: 10.1177/1533317510385807

The Singer or the Singing: Who Sings Individually to Persons With Dementia and What Are the Effects?

Wendy Chatterton 1, Felicity Baker 2, Kylie Morgan 3
PMCID: PMC10845674  PMID: 21131670

Abstract

‘‘Live’’ singing to persons with dementia (PWDs) may be an underused but highly accessible resource for their caregivers, regardless of qualifications. A systematic literature review sought to illuminate who sings to PWDs, and with what objectives and effects, to address the question of whether it is the singer or the singing which is effective. The literature revealed that music therapists seek to address cognitive, behavioral, physiological, and social factors through one-to-one singing, whereas other caregivers are more broadly concerned with quality of life, often through facilitating activities of daily living. All included studies concurred that individual singing to PWDs can be effective in a variety of ways, depending on contexts and goals. PWD’s perceptions of situations may influence the effectiveness of singing interventions. Music therapists are urged to empower professional caregivers to sing sensitively to PWDs during caregiving activities.

Keywords: dementia, Alzheimer’s disease, caregiver, singing, music therapy

Full Text

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Contributor Information

Wendy Chatterton, The University of Queensland, Brisbane, Queensland, Australia, chatterton@iinet.net.au .

Felicity Baker, The University of Queensland, Brisbane, Queensland, Australia.

Kylie Morgan, The University of Queensland, Brisbane, Queensland, Australia.

References

  1. Ridder HM An overview of therapeutic initiatives when working with people suffering from dementia. In: Aldridge D, ed. Music Therapy and Neurological Rehabilitation: Performing Health . London: Jessica Kingsley; 2005:61-82. [Google Scholar]
  2. Ridder HM, Wigram T., Otteson AM A pilot study on the effects of music therapy on frontotemporal dementia: developing a research protocol. J Music Ther. 2009;18(2):103-132. [Google Scholar]
  3. Brown S., Gotell E., Ekman S. ‘Music-therapeutic caregiving’ the necessity of active music-making in clinical care. Arts Psychother. 2001;28(2):125-135. [Google Scholar]
  4. Brown S., Gotell E., Ekman S. Singing as a therapeutic intervention in dementia care. J Dementia Care. 2001;9(4):33-37. [Google Scholar]
  5. Gotell E., Brown S., Ekman S. Caregiver singing and background music in dementia care. West J Nurs Res. 2002;24(2):195-216. [DOI] [PubMed] [Google Scholar]
  6. Gotell E., Brown S., Ekman S. Influence of caregiver singing and background music on posture, movement, and sensory awareness in dementia care. Int Psychogeratr. 2003;15(4):411-430. [PubMed] [Google Scholar]
  7. Gotell E., Brown S., Ekman S. The influence of caregiver singing and background music on vocally expressed emotions and moods in dementia care: a qualitative analysis. Int J Nurs Stud. 2009;46(4):422-430. [DOI] [PubMed] [Google Scholar]
  8. Bright R. Muisc Therapy and the Dementias: Improving the Quality of Life. St Louis, MO: MMB; 1998. [Google Scholar]
  9. Clair AA The importance of singing with elderly patients. In: Aldridge D, ed. Music Therapy in Dementia Care: More New Voices. London: Jessica Kingsley; 2000. [Google Scholar]
  10. Stokes G. And Still the Music Plays-Stories of People with Dementia. London: Hawker Publications; 2008. . [Google Scholar]
  11. Brotons M., Koger SM, Pickett-Cooper P. Music and dementias: a review of the literature. J Mus Ther. 1997;34(4):204-245. [Google Scholar]
  12. Nugent N. Agitated behaviours in Alzheimer’s disease and related disorders: music and music therapy research. Aust J Music Ther. 2002;13:38-51. [Google Scholar]
  13. Vinks AC, Birks J., Bruinsma MS, Scholten RJ Music therapy for people with dementia. Cochrane Database Syst Rev. 2003;4: CD003477. [DOI] [PubMed] [Google Scholar]
  14. World Health Organization, Global burden of disease. Part 3: disease incidence, prevalence and disability . 2004. [cited 2010. March 1]. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part3.pdf . Accessed March 1, 2010. [Google Scholar]
  15. Alzheimer’s association. 2009 Alzheimer’s disease facts and figures. 2009. http://www.alz.org/national/documents/report_alzfactsfigures2009.pdf . Accessed March 2, 2010. [Google Scholar]
  16. Ballard C., Margallo LM, Theodoulou M., et al. A randomized, blinded, placebo-controlled trial in dementia patients continuing or stopping neuroleptics (The DART-AD Trial). PLoS Med. 2008;5(4). http://www.telegraph.co.uk/news/main.jhtml?xml=/ news/2008/04/01/nalzheim101.xml. Accessed Febuary 1, 2010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ballard C., Hanney ML, Theodoulou M., et al. The dementia anti-psychotic withdrawal trial (DART-AD): long-term follow-up of a randomized placebo-controlled trial. Lancet Neurol. 2009; 8(2): 151-157. http://www.thelancet.com/journals/lancet/article/PIIS1474-4422(08)70295-3 . Accessed Febuary 1, 2010. [DOI] [PubMed] [Google Scholar]
  18. Australian Government Department of Health and Ageing. [Online] Dementia Resource Guide. 2008. http://www.health.gov.au/internet/main/publishing.nsf/content/ageing-dementia-resource-guide.htm . Accessed November 6, 2009. [Google Scholar]
  19. BBC News. [Online] New push to end dementia stigma. 2009. http://news.bbc.co.uk/2/hi/uk_news/politics/7863649.stm. Accessed November 6, 2009. [Google Scholar]
  20. Kitwood T., Bredin K. Towards a theory of dementia care: person-hood and well-being. Ageing Soc. 1992;12:269-287. [DOI] [PubMed] [Google Scholar]
  21. Kitwood T. Dementia Reconsidered: The Person Comes First. Buckingham: , England: Open University Press; 1997. [Google Scholar]
  22. Davis C. Hugs not drugs for dementia. Nurs Stand. 2009. ; 23(32):22-23. [DOI] [PubMed] [Google Scholar]
  23. James O. Contented Dementia. London: Vermilion; ; 2008. [Google Scholar]
  24. Rose L., Schlingensiepen S. Meeting in the dark: a musical journey of discovery. J Dementia Care. 2001;9(2):20-24. [Google Scholar]
  25. Sloane P., Hoeffer B., Mitchell CM, et al. Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial. J Am Geriatr Soc. 2004;51(11):1795-1804. [DOI] [PubMed] [Google Scholar]
  26. Norberg A. Consoling care for people with Alzheimer’s disease or another dementia in the advanced stage. Alzheimers Care Q. 2001;2(20):46-52. [Google Scholar]
  27. Harmer BJ, Orrell M. What is meaningful activity for people with dementia living in care homes? A comparison of the view of older people with dementia, staff and family carers . Aging Ment Health. 2008;12(5):5487-5558. [DOI] [PubMed] [Google Scholar]
  28. Kihlgren M. , Hallgren A., Norberg A., Karlsson I. Disclosure of basic strengths and basic weaknesses in demented patients during morning care, before and after staff training: analysis of video-recordings by means of the Erikson theory of ‘‘eight stages of man.’’. Int J Aging Hum Dev. 1995;43(3):219-233. [DOI] [PubMed] [Google Scholar]
  29. Cohen-Mansfield J., Mintzer JE Time for change: the role of non-pharmacological interventions in treating behavior problems in nursing home residents with dementia. Alzheimer Dis Assoc Disord. 2005. ;19(1):37-40. [DOI] [PubMed] [Google Scholar]
  30. Kovach CR, Noonan PE, Schildt AM, Reynolds S., Wells T. The serial trial intervention: an innovative approach to meeting needs of individuals with dementia. J Gerontol Nurs. 2006;32(4):18-25. [DOI] [PubMed] [Google Scholar]
  31. Vanstone AD , Cuddy LL Musical memory in Alzheimer’s Disease . Neuropsycho Dev Cogn B Aging Neuropsycho Cogn. 2010;. 17(1):108-128. [DOI] [PubMed] [Google Scholar]
  32. Cady ET, Harris RJ, Knappenberger JB Using music to cue autobiographical memories of different lifetime periods . Psychol Music. 2008;36(2):157-177. [Google Scholar]
  33. Foster NA, Valentine ER The effect of auditory stimulation on autobiographical recall in dementia . Exp Aging Res. 2001;27(3):498-510. [DOI] [PubMed] [Google Scholar]
  34. Salimpoor VN , Benovoy M., Longo G., Cooperstock JR The rewarding aspects of music listening are related to degree of emotional arousal. PLoS One. 2009;4(10):e7487. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Labbe E., Schmidt N., Babin J., Pharr M. Coping with stress: the effectiveness of different types of music. Appl Psychophysiol Biofeedbak. 2007;32(3-4):163-168. [DOI] [PubMed] [Google Scholar]
  36. Brotons M., Marti P. Music therapy with Alzheimer’s patients and their family caregivers: a pilot project. J Music Ther. 2003;40(2):138-150. [DOI] [PubMed] [Google Scholar]
  37. Brotons M., Pickett-Cooper PK The effects of music therapy intervention on agitation behaviors of Alzheimer’s disease patients. J Music Ther. 1996;33(1):2-18. [Google Scholar]
  38. Clair AA, Bernstein B. The effect of no music, stimulative background music and sedative background music on agitated behaviors in persons with severe dementia. Act Adapt Aging. 1994;19(1):61-70. [Google Scholar]
  39. Fitzgerald-Cloutier ML The use of music therapy to decrease wandering: an alternative to restraints. Music Ther Perspect. 1993;11(1):32-36. [Google Scholar]
  40. Groene RW II. Effectiveness of music therapy 1:1 intervention with individuals having senile dementia of the Alzheimer’s type. J Music Ther. 1993;30(3):138-157. [Google Scholar]
  41. Jennings B. , Vance D. The short-term effects of music therapy on different types of agitation in adults with Alzheimer’s. Act Adapt Aging. 2002;26(4):27-33. [Google Scholar]
  42. Lesta B., Petocz P. Familiar group singing: addressing mood and social behaviour of residents with dementia displaying sundowning. Aus J Music Ther. 2006;17:2-17. [Google Scholar]
  43. Ridder HM, Aldridge D. Individual music therapy with persons with frontotemporal dementia. Nordic J Music Ther. 2005;14(2):91-106. [Google Scholar]
  44. Robertson-Gillam K. Hello in there. Music Council of Australia. 2007;13(2). http://www.mca.org.au/web/content/view/84/6. Accessed July 4, 2009. [Google Scholar]
  45. Silber F., Hes J. The use of songwriting with patients diagnosed with Alzheimer’s disease . Music Ther Perspect. 1995;13(1):31-34. [Google Scholar]
  46. Mathews RM, Clair AA, Kosloski K. Brief in-service training in music therapy for activity aides: increasing engagement in persons with dementia in rhythm activities. Act Adapt Aging. 2000;24(4):41-49. [Google Scholar]
  47. Nolan P. What to do until the music therapist arrives? Developing therapeutic activities using music. Holist Nurs Pract. 2006;20(1):37-40. [DOI] [PubMed] [Google Scholar]
  48. Rio R. Connecting Through Music With People With Dementia: A Guide for Caregivers . London: Jessica Kingsley; 2009. [Google Scholar]
  49. Bannan N., Montgomery-Smith C. ‘Singing for the brain’: reflections on the human capacity for music arising from a pilot study of group singing with Alzheimer’s patients . J R Soc Promot Health. 2008;128(2):73-78. [DOI] [PubMed] [Google Scholar]
  50. Gori G., Vespa A., Magherini L., Ubezio MC The day center for demented people: organization, programs and evaluation methods. Arch Gerontol Geriatr. 1998;26(1):241-246. [Google Scholar]
  51. Kelleher AY The beat of a different drummer: music therapy’s role in dementia respite care. Act Adapt Aging. 2001;25(2):75-84. [Google Scholar]
  52. Gotell E., Brown S., Ekman S. Caregiver-assisted music events in psychogeriatric care. J Psychiatr Ment Health Nurs. 2000;7(2):119-125. [DOI] [PubMed] [Google Scholar]
  53. Sherratt K. , Thornton A., Hatton C. Emotional and behavioral responses to music in people with dementia: an observational study. Aging Ment Health. 2004;8(3):233-241. [DOI] [PubMed] [Google Scholar]
  54. Smith-Marchese K. The effects of participatory music on the reality orientation and sociability of Alzheimer’s residents in a longterm-care setting. Act Adapt Aging. 1994;18(2):41-55. [Google Scholar]
  55. Foster B. Unlocking life’s souvenirs: music’s impact in late-stage dementia . Can Nurs Home. 2007;18(2):23-25. [Google Scholar]
  56. Gerdner LA Effects of individualized versus classical ‘relaxation’ music on the frequency of agitation in elderly persons with Alzheimer’s disease and related disorders. Int Psychogeriatr. 2000;12(1):49-65. [DOI] [PubMed] [Google Scholar]
  57. Gerdner LA, Swanson EA Effects of individualized music on confused and agitated elderly patients . Arc Psychiatr Nurs. 1993;7(5):284-291. [DOI] [PubMed] [Google Scholar]
  58. Goddaer J., Abraham IL Effects of relaxing music on agitation during meals among nursing home residents with severe cognitive impairment. Arc Psychiatr Nurs. 1994;8(3):150-158. [DOI] [PubMed] [Google Scholar]
  59. Goodall D., Etters L. The therapeutic use of music on agitated behavior in those with dementia. Holist Nurs Prac. 2005;19(6):258-261. [DOI] [PubMed] [Google Scholar]
  60. Hicks-Moore SL Relaxing music at mealtime in nursing homes: effects on agitated patients with dementia. J Gerontol Nurs . 2005;31(12):26-32. [DOI] [PubMed] [Google Scholar]
  61. Hicks-Moore SL, Robinson BA Favorite music and hand massage: two interventions to decrease agitation in residents with dementia. Dementia . 2008;7(1):95-108. [Google Scholar]
  62. Ragneskog H. , Kihlgren M., Karlsson I., Norberg A. Dinner music for demented patients: analysis of video-recorded observations. Clin Nurs Res. 1996;5(3):262-277. [DOI] [PubMed] [Google Scholar]
  63. Heim C., Nair BK, Mowbray D., Tavender J. Effects of ambient baroque music on patients with dementia. Aust J Ageing. 2003;22(4):211-212. [Google Scholar]
  64. Madan S. Music intervention for disruptive behaviors in long-term care residents with dementia. Annu Longterm Care. 2005. 13(12):33-36. http://www.annalsoflongtermcare.com/article/5085.AccessedJuly 10, 2009. [Google Scholar]
  65. Thomas DW, Heitman RJ, Alexander T. The effects of music on bathing cooperation for residents with dementia. J Music Ther. 1997;34(4):246-259. [Google Scholar]
  66. Thomas DW, Smith M. The effect of music on caloric consumption among nursing home residents with dementia of the Alzheimer’s type. Act Adapt Aging. 2009;33(1):1-16. [Google Scholar]
  67. Carruth EK The effects of singing and the spaced retrieval technique on improving face-name recognition in nursing home residents with memory loss. J Music Ther. 1997;34(3):165-186. [Google Scholar]
  68. Christie ME Music therapy applications in a skilled and intermediate care nursing home facility: a clinical study. Act Adapt Aging. 1992;16(4):69-87. [Google Scholar]
  69. Clair AA The effects of singing on alert responses in persons with late stage dementia . J Music Ther. 1996;33(4):234-247. [Google Scholar]
  70. Clair AA The effects of music therapy on engagement in family caregiver and care receiver couples with dementia. Am J Alzheimers Dis Other Demen. 2002;17(5):286-290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  71. Clair AA, Bernstein B. A comparison of singing, vibrotactile and nonvibrotactile instrumental playing responses in severely regressed persons with dementia of the Alzheimer’s type. J Music Ther. 1990;27(3):119-125. [Google Scholar]
  72. Pollack NJ, Namazi KH The effect of music participation on the social behavior of Alzheimer’s disease patients. J Music Ther. 1992;29(1):54-67. [Google Scholar]
  73. Lipe A. The use of music in performance tasks in the assessment of cognitive functioning among older adults with dementia. J Music Ther. 1995;32(3):137-151. [Google Scholar]
  74. Perry B. Core nursing values brought to life through stories. Nurs Stand. 2005;20(7):41-48. [DOI] [PubMed] [Google Scholar]
  75. Smith DB Staffing and managing special care units for Alzheimer’s patients: special care units call for special people-both caregivers and managers. Geriatr Nurs. 1995;16(3):124-127. [DOI] [PubMed] [Google Scholar]
  76. Folstein MF , Folstein SE, McHugh PR ‘Mini-Mental State ’: a practical method for grading the cognitive state of patients of the clinician. J Psychiatr Res. 1975;12(3):189-198. [DOI] [PubMed] [Google Scholar]
  77. Reisberg B. , Ferris SH, de Leon MJ, Crook T. The global deterioration scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982;139(9):1136-1139. [DOI] [PubMed] [Google Scholar]
  78. Alzheimer’s treatment overview. [Online]. 2010; [4 screens] Fisher Center for Alzheimer’s Research Foundation. http://www.alzinfo.org/alzheimers-treatment-overview.asp . Accessed August 4, 2010. [Google Scholar]

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